Dept. of Orthopaedics, University of North Carolina, Chapel Hill, NC, United States.
School of Osteopathic Medicine, Campbell University, Lillington, NC, United States.
Knee. 2021 Dec;33:210-215. doi: 10.1016/j.knee.2021.10.011. Epub 2021 Oct 26.
Therapies for arthrofibrosis after knee surgery are needed to prevent loss of joint function. Interleukin-1 receptor antagonists (IL-1RA) have shown promise in treating established arthrofibrosis in pilot clinical studies. The objective of this study was to evaluate the ability of intra-articular injection of IL-1RA to prevent knee joint contracture in a post-traumatic knee immobilization model.
20 male Sprague Dawley rats were block randomized into two groups: control and IL-1RA. Rats underwent intra-articular surgical trauma of the right knee with placement of an immobilization suture, securing the knees in 150° flexion. On post-operative days 1 and 8, each group received a 0.1 ml intra-articular injection of either saline (control) or anakinra (IL-1RA:single dosage; 2.63 mg/kg). Rats were euthanized fourteen days after surgery and the immobilization femorotibial angles were measured on the operative limbs with the suture and musculature intact. Subsequently, musculature was removed and femorotibial angles were measured in the operative and non-operative limbs with a defined extension moment applied with the posterior capsule intact or cut. A contracture angle was calculated as the angular difference between the operative and non-operative limb.
The immobilization knee flexion angle did not differ (P = 0.761) between groups (control: 152 ± 9; IL-1RA: 150 ± 11). The joint contracture angles (smaller angle = improved outcome) were reduced by 12 degrees on average in the IL-1RA group compared to the control for both the capsule intact (P = 0.024) and cut (P = 0.019) states.
Intra-articular IL-1RA injection was found to diminish knee extension deficits associated with arthrofibrosis in a post-traumatic joint immobilization model.
需要治疗膝关节手术后的关节纤维性僵直，以防止关节功能丧失。白细胞介素-1 受体拮抗剂（IL-1RA）在治疗已确立的关节纤维性僵直的初步临床研究中显示出前景。本研究的目的是评估关节内注射 IL-1RA 预防创伤后膝关节固定模型中膝关节挛缩的能力。
20 只雄性 Sprague Dawley 大鼠采用随机分组，分为对照组和 IL-1RA 组。大鼠右膝关节进行关节内手术创伤，用固定缝线固定，将膝关节固定在 150°屈曲位。术后第 1 天和第 8 天，每组分别接受 0.1ml 关节内注射生理盐水（对照组）或 anakinra（IL-1RA：单次剂量；2.63mg/kg）。术后 14 天处死大鼠，完整保留缝线和肌肉的情况下，测量术侧膝关节固定的股骨胫骨角度。然后，去除肌肉，在完整保留后囊的情况下或切断后囊的情况下，在术侧和非术侧施加一定的伸展力矩，测量股骨胫骨角度。计算挛缩角度作为术侧和非术侧之间的角度差异。
两组膝关节固定屈曲角度无差异（P=0.761）（对照组：152±9；IL-1RA 组：150±11）。在保留后囊和切断后囊的情况下，IL-1RA 组的关节挛缩角度（角度越小表示结果越好）平均分别比对照组减少 12 度。
在创伤后关节固定模型中，关节内注射 IL-1RA 可减少与关节纤维性僵直相关的膝关节伸展不足。
